Individual
MS. CAROL ANN MARTIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3 TECHNOLOGY DR, SUITE 700, EAST SETAUKET, NY 11733-4064
(631) 444-5220
(631) 444-5225
Mailing address
21 ORBIT DR, STONY BROOK, NY 11790-3015
(631) 751-3752
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302776-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02377728
—
NY
Enumeration date
10/28/2005
Last updated
07/08/2007
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